动脉化静脉皮瓣成活机制的实验研究

目的 直视下观测动脉化静脉皮瓣的血液循环途径,探讨其成活机制。方法 选用15只中国大白兔30只耳朵,设计动脉化静脉皮瓣模型,应用微循环显微镜在不同时间观察皮瓣微循环的血液途径(1h、2h、4h、8h)。结果 皮瓣全部成活。皮瓣组织内毛细管管网是一个“立体”的网状结构;静脉皮瓣早期可见毛细血管床关闭,动脉血在微静脉间快速流动;随毛细血管逐渐开放,动脉血逆流进入微循环,完成循环重建。结论在引流静脉保持通畅的前提下,静脉皮瓣可借助静脉系统重建有效血液循环并保持成活。

Experimental Study of the Survival Mechanism of Non-physiological Blood Perfusion of Arterialized Venous Flap

Objective To investigate the microcirculative route of the arterialized venous flap.Methods Selecting 15 Chinese white rabbits designed the model of arterialized venous flap by anastomosis with from the central artery to central vein.The reversed blood flow perfusion was directly observed by the "ear windows" under the microscope and,simultaneous recording the changes in the microcirculation of the flap.Results All of the flaps were alived.The structure of the capillary net in the flap was a stereo-net .In the early arterialized stage,the upstream blood flows quickly in the venule;there was no blood flowing in the capillary net with the opening of the capillary net,the reconstructed procedure of the non-physilogical microcirculation was accomplished:the arterial blood mainly flow through small vein and venule,finally arrived the capillary net.Conclusions Keep up the drainage vein free,the arterialized venousflap could be alived by reconstructed effective microcirculation through the venous system.